Intensive English Program (IEP)
Application for F-1 status (form I-20)
(Please print out this form and mail it to Century School of Languages)
Family Name (Surname):
First Name:
Address in Home Country:
Gender: Male Female Date of Birth:
E-mail:
Country of Birth:
Country of Citizenship:
Are you planning to attend an American College or University? Yes No
If yes, do you have a college degree from a University of your Country?  Yes No
Degree
TOEFL Score
Projected Length of Attendance at Century School of Languages:
3 months 6 months 9 months 12 months
(3months minimum session for I-20 students)
Date student expects to bigin
 　Complete　　studies at Century School
Financial Statement
Century School of Languages is required by the United States Immigration Service to obtain evidence that shows that you are financially able to support yourself for the entire period of stay in the USA, while you are taking a full course of study.
Source of Funds:
*If funds from Student or Family (Attach a Certified Bank Statement in U.S. Dollars)
Name of Student or Family providing funds
Relationship
*If funds are from a Sponsor or Relative in the United States; Attach INS form I-134
Name of Sponsor or Relative
Telephone Number
Students Financial Declaration:
Enclosed is my check for US $100 to cover my I-20 application and registration fee. (Application forms will not be processed if application and registration fees are not enclosed.) The required refundable registration fee will be refunded only if a student is denied entry into the United States.  You must provide official documentation from the US consulate verifying this fact, and a refund must be requested within six months from the date of application.
I certify that the information given above is a correct statement of my arrangements for financing my studies at Century School of Languages.
 
 
Student’s Signature / Date
Name of applicant or person preparing form, if other than applicant (Or Contact Person in the U.S.A)
Name (printed or typed)
Telephone Number
Address
State/Province
Postal Code
Country